This paper was written by Matt Sloan for the Living Routes program in the Spring of 2007:


Abstract:

Siddha medicine, a traditional healing practice native to South India, is currently positioned in an era of change. Siddha has been challenged to integrate foreign elements into its practice throughout its history. Today the force of globalization is acting to shape the practice, for better or for worse. Practitioners today are concerned as some aspects of Siddha are appropriated by the global market, notably drugs and medicals, while the holistic approaches are neglected. I interviewed practitioners and healers in the Auroville area, and evaluated works on the history of Siddha, Ayurveda and globalization. Though the future of Siddha is uncertain, it is unlikely the practice will soon be eradicated. Government colleges are training a body of new practitioners, and Siddha is now on the WHO’s list of Ethnomedicines. Today’s Siddha practitioners, however, are relying less on ancient texts and more on modern medical techniques. Two questions remain: “How will this change affect the future of Siddha?” and “How sustainable are these new practices?”

Part One: Foreword

The United States has been wrought by conflict between the corporate/political powers-that-be and the desires of the populace since the Vietnam era. The participants of that age of protest grew to become the teachers and mentors for a new, younger generation. The youth latched on to the examples set for them by their elders and have successfully fostered a tradition of openness to dissent against unjust acts. In this spirit, programs have been developed that allow students to dive into today’s most impassioned civil issues.
At the top of the list of political issues, a generational mainstay since the publication of Rachel Carson’s eye-opening novel, Silent Spring, stands the topic of environmental responsibility. Today in the face of global warming alerts, weapons of mass destruction, peak oil disasters, water wars and countless other worries stemming from environmental degradation and irresponsibility, there is a popular buzzword being increasingly uttered in classrooms across the country – “sustainability.” It was a vague understanding and desire to learn more about this concept that drew me to participate in the Living Routes program based in Auroville.
Living Routes is an opportunity for college students to study abroad in places as diverse as West Africa and Western Massachusetts. The Auroville program is based in Tamil Nadu, a southeastern Indian state. The twenty-four participants of the program live in community and dissect the concept of sustainability from every angle. The environment of Auroville, a society founded on the ideas and vision of two great thinkers, Sri Aurobindo and The Mother, is an ideal setting for this learning process. Sri Aurobindo and the Mother set up this progressive city as “an experiment in human unity.” Since this time over forty years ago, roughly 2,000 liberal-minded thinkers have been attracted to the city. The dream of the Mother included a population in Auroville of 50,000.
Tamil Nadu is an ideal place for me to begin looking at a phenomena that is sweeping through the field of traditional medicine. This region is home to an ancient medical practice known as Siddha. The impression I got from a local herbal provider is that “all the villagers rely on Western medicine.” (Shivaraj) The same opinion is reiterated in Jean Langford’s Fluent Bodies, a comprehensive look at postcolonial Ayurvedic practice in India. Further, as a nation on an expediently globalizing and homogenizing planet, I am interested in what impact the, once remote, West has had on the modernization of traditional practices. India’s cultural and medicinal traditions are undeniably affected by these global forces, for better or for worse. I hope to evaluate where these practices may be headed in the future.
As part of the Auroville program, students partake in a three-week internship, participating in some aspect of the community. I have had the opportunity to meet and interview vaidyas (traditional doctors) about their thoughts on the state and future of modern Siddha medicine. I have also been able to work with Aurovilian sustainable farmers who are working to revitalize traditional knowledge of both medicinal and agricultural plants, caretakers of two local medicinal plant sanctuaries (Pitchandikulam and Martuvam) and researchers from a nearby medicinal studies institute, Institut Francais Pondicherry.
I am relying on comparable research as carried out by Jean Langford and viewed through her publication, Fluent Bodies. Other important works being used in my examination of this topic include: Earth Democracy: Justice, Sustainability, and Peace by Vandana Shiva for information on British colonial impact in India and globalization; Siddha Medicine: A Handbook of Traditional Remedies by Dr. Paul Joseph Thottam for information on the history of the Siddha practice; and selections from the United Nations Development Programme, Volume 10, Sharing Innovative Experiences. With these sources as foundation, I hope to compile an accurate, if not complete, picture of where modern Siddha stands, my vision for its future, and what relevance, if any, this may have on the patients directly affected by its practice in Tamil Nadu, and those persons indirectly affected by Siddha in the West, such as medical practitioners, global activists, cultural scholars, travelers, and others.

Part Two: History of Siddha (/Ayurveda) Through the Time of British Departure

Mythologically decreed to have been invented by the god, Lord Siva, Sir John Marshall’s excavation in 1921 of the Indus River Valley civilization dates the practice of Siddha back eight thousand years. (Thottam 3) It is, however, the siddhars (scholars or saints) who are credited with the creation of this medical practice. Among their contributions are “palm leaf manuscripts on many subjects, including medicine, psychiatry and surgery.” The exact date of these ancient publications is unclear. (Thottam 7) Further, the Pathinen (eighteen) siddhars said to have contributed to the collective knowledge of Siddha medicine are now believed to be as many as twenty-five with nationalities beyond Tamil, including, perhaps, Chinese and Roman. (Thottam 12)
“Siddha medicine is characterized by the diversity of therapeutic approaches which work together to promote holistic healing… [including] both traditional as well as modern aspects.” (Thottam x) In this regard, Siddha has historically been seen as a practice open to integrating the exogenous medical practices with which it comes into contact. I will assess later how this history compares with the way Siddha, today, interacts with Western biomedical practices.
The shift that has transformed Siddha into the practice seen today began during the British colonization of India. Siddha subsequently developed into its modern state in the postcolonial era. The impact of the colonial era and its resultant effects (including the rise of globalization) will be discussed later in this paper.

Note: For all intents and purposes, Siddha medicine is analogous to the more widely known practice of Ayurveda. The two terms may be used interchangeably throughout the rest of this paper. The differentiation stems from a translation of the ancient Ayurvedic texts into the local language of Tamil, and will not have a great bearing on my investigation.

Part Three: Siddha Practice Today

Today’s practice of Siddha medicine is one greatly transformed from the ancient tradition. Jean Langford looks specifically at the practices of three Ayurvedic vaidyas in an attempt to understand how the practice is changing over time. She identifies the emergence of three vastly different perspectives within Ayurveda in three sequential generations of practitioners. Langford attributes these apparent disparities to varying levels of resistance to modern medicine, and cites a “postcolonial identity problem” as the cause of this discontinuity. (Langford 25)
Looking at the first practitioner, Langford sees a resistance against science itself. The eldest of the three practitioners, this physician takes a very traditional approach to healing. This type of practice focuses predominantly on “going deep” and defining the patient’s dosa. “The diagnosis consists primarily of darsan and of talking to the patient…[and] includes an examination of tongue, eyes, skin color, and so on.” (Langford 29) The vaidya takes the patient’s pulse to define the dominant dosa. This is done as a traditional assessment and not a diagnostic calculation, as it is used in Western practice. Though this physician will, on occasion, use modern diagnostics (such as a hemoglobin count) he values the word of the patient over laboratory results. (Langford 30) This vaidya is truly the most traditional of the three interviewed by Langford, as well as the oldest.
In sharp contrast, the second vaidya is a product of a generation that utterly embraces biomedical approaches. He relies heavily and unabashedly on modern technology and diagnostic tools. There is a fairly rigid distinction between the Ayurvedic, holistic view of the human body and the biomedical, anatomical view of the body. Langford notes that for the second practitioner “the anatomical body was the bottom line.” (Langford 39) Here, the practitioner seems more a biomedical doctor than a vaidya. He is ready to criticize the use of traditional Ayurveda in a modern world, claiming that “the changed environment, prevalence of pollution, [and] the noncircadian rhythm of modern schedules” (Langford 40) makes it nearly impossible for today’s patient to rely on a practice that was born in a starkly different era.
This vaidya insists upon the necessity for plasticity and transparency between allopathy and Ayurveda. There is no “holistic versus atomistic” duality, no “whole body, half body.” (Langford 43) Looking at Ayurveda as an anthropological specimen, an object to be studied by science degrades it from its place as science. To say that Ayurveda is better than biomedicine in some regards and that biomedicine is better in other ways creates a barrier to information that isolates the two practices. In my interview with Dr. Loganathan, he discusses a similar problem with this comparison. Both practitioners imply that modern Ayurveda are part of a globalized world. As part of this global world Ayurveda belongs to the same “Universal Tradition” as biomedicine and Western practice.
The third practitioner detailed by Langford is from the most modern generation of vaidyas. Langford points out that if the first physician focused his diagnoses on “darsan,” and the second on “modern technologies,” this final practitioner could be said to focus on “conversation.” (Langford 48) This vaidya seems to practice a form of Ayurveda that is equally integrative of traditional and modern approaches. Langford explains that he will assess a patient’s dosa and then define the findings in modern disease terms. This younger practitioner will incorporate the holistic components of diet and psychology into diagnoses, something the middle generation vaidya omitted from his treatments. In this way the third practitioner values the deep interaction of traditional Ayurveda over the hectic and brief relations advocated by the biomedical approach. The deep interaction with patients and the psychological assessments are neglected by the second, modernized vaidya.
Interestingly, when describing the practice of the third vaidya, Langford points out that modern Ayurveda is operating in “a time when the confidence of urban and many rural Indians seems to have turned away from Ayurveda towards biomedicine. Ayurvedic physicians employ different strategies to win it back. [The second doctor] attempts to erase the differences between Ayurveda and biomedicine. [The third], however, assembles those differences into a marketable commodity.” (Langford 53) This commodification of Ayurveda may be essential to the modern revival of traditional Ayurveda, but as Dr. Loganathan emphasizes, it may not be in the patient’s best interest.
During my interview with Dr. Loganathan I noticed a great deal of overlap with his thoughts on modern Siddha in the face of a globalized world and the second vaidya interviewed by Langford. Both favor integration in their fields of practice. Dr. Loganathan was adamant about incorporating the best method available for treating illness, regardless of where in the world it originated. He cites the global use of the Madagascan periwinkle in leukemia treatment and the integration of Korean ginseng into Indian practice as prime examples. The idea of a “universal tradition,” as proposed by Dr. Loganathan, infers that no one culture can (or should) claim a successful healing strategy as its own. According to Dr. Loganathan there are now over 150 drugs in “global medicine,” used by practitioners across the globe in all different cultures. Sharing successful medicinal strategies and information as part of a globalized tradition may have some unexpected repercussions. Before I continue with Dr. Loganathan’s assessment of the future of Siddha, I want to look at the possible consequences of globalization. To do this I will briefly investigate arenas, both in and outside of medicine, where globalization and its aftermath have already taken place.


Part Four: Impact of Globalization on Siddha Practice – Intellectual Property Rights/Biopiracy, Institutionalization/Professionalization, Standardization, Commodification for the West

There is scarcely a sanctuary left on this planet that remains free from the impact of corporate globalization. Siddha and other traditional practices are now viewed as products ripe for global consumption. My investigation hopes to determine what effect this has had in shaping modern Siddha. I am also interested in describing the likely future of this traditional practice.
The word Ayurveda has come to embody different meanings. In order to increase credibility among international health practices, Jean Langford notes that the definition of Ayurveda has been altered from “the knowledge of life” to “the science of life.” (Fluent 4) Another student of the practice poignantly and concisely describes Ayurveda as “anything that heals.” (Pavan Kanwar speech) I like this definition because it does not bow down to the supremacy of Western health standards. Rather, this definition integrates all health practices, including biomedical, into the broad umbrella of Ayurveda. Regardless of how the term is defined, encompassee or encompassor of biomedicine, the forces of globalization are changing the face of modern Ayurveda from its traditional practice.
The question to ask now is not if changes will happen, but rather, what will the future of this altered tradition look like The scenario that Langford’s second (biomedically-influenced) vaidya proposes is that the practice will hold stubbornly to its ancient roots. In his opinion, this will create stagnation in the practice and will likely transform Ayurveda into a cultural relic (Fluent 53). Further repercussions could be the sale of Ayurveda’s scientifically testable components to the “universal tradition,” neglecting the holistic approach that was once imperative to the practice. The West has money and power in today’s medical market. This gives the West an advantage in scientifically researching traditional strategies. It is this scientific testability that compromises the non-drug aspects of traditional practices. Patients (and many practitioners) today place increasing importance on clinical research. For this reason, there is a challenge to integrate the important parts of Ayurveda, such as “deep interaction”, into the “universal tradition.” (Loganathan interview) This is a shortcoming that the universal tradition must remedy if it hopes to realize its position as the most effective treatment for a global population.
Another scenario that Langford touches on is seen in the third (conversationalist) vaidya interview. This attempt to equally integrate the traditional and modern elements into a cohesive practice is increasing in popularity. I believe that it is in the best interest of every patient to seek a practitioner of a globally integrated tradition. Dr. Loganathan makes it clear that a tradition with a 4,000 year history does not survive by being stubborn. Siddha is always evolving, and can only survive by including new approaches. Recent inclusions have been biomedical diagnostic tools and effective treatments from other cultures, such as Korean ginseng and Madagascan periwinkle. (Loganathan interview) I believe that the best tradition is the one that maximizes health, regardless of what culture's texts claim the practice of their own.
In Loganathan's "Universal Tradition," there are two essential rules:
1) No patient should be prevented from receiving any effective medical treatment. Stated simply, "Every human being has a right to the best medicine."
2) Doctors from every tradition require links and correlations to all other current practices. (Loganathan)
It is my opinion that physicians from every medical tradition should be working toward creating this functional, Universal Tradition. This does not necessitate the demise of Ayurveda or Siddha or biomedicine. Rather, it can be a tool for enhancing the repertoire of treatments available to every practitioner in the world.
First, it is important to step back and look at the Indian history which has brought Ayurveda to such a critical point. In Jean Langford’s view, the British control of the subcontinent in colonial times is key to understanding the modern pressures being exerted on Ayurveda. In 1757, it was the first global corporation, The East India Company, that changed from merchants into the rulers of the continent as Bengal fell. (Shiva, 28) With the British in control, Langford sites 1836 as the significant moment of medicinal takeover, marked by the symbolic “fifty-round cannon salute to celebrate the first dissection of a cadaver by a group of Indians.” (Fluent 5) In fact, as Langford continues, these blasts marked only an end to British interest in studying Ayurveda side-by-side with European practices, as a policy of conducting all higher education in English was subsequently instituted. Even though the British had, by this time, been studying the Ayurvedic texts for years, the officials ordering the salute must have forgotten that those ancient texts refer specifically to the performance of surgeries millennia prior to this festive occasion. This booming temporal boundary is essential because it sets the stage for the later mimicry of the European educational system that occurs in the postcolonial era as India began organizing its own Ayurvedic institutions.
These new institutions, founded in postcolonial India, were similar to the British schools that preceded them. Equipped with “drug companies, colleges, and textbooks” Ayurveda had “a new authority,” (Fluent 8) that had become substantiated by its “place in the World Health Organization’s compendium of ethnomedicines.” (Fluent 8) Langford believes that it is this partial or “metonymic” mimicry of the Western institutions that granted Ayurveda leveraging power in dialogues on medical procedure and the opportunity to “redefine science itself.” (8) With schools and drug companies operational, Ayurveda is poised to be taken seriously by the global community. Economically speaking, this puts the marketable fruits of Ayurveda (namely medications), in perfect position to be appropriated by profit-driven companies, as has been evidenced by the controversial misuse of neem medications.
Though beneficial for the global power standing of Ayurveda, I believe that this shift toward institutionalization has led directly to a decrease in the practice’s “sustainability”. Here, I define sustainability as the ability for the practice to be perpetuated without negatively impacting the environment, now or in the future. An upsurge in the number of Ayurvedic drug companies necessitated new laws by the Indian government on standardization of products. Foreign importers also required a guaranteed product, which further necessitated this standardization.
What impact will this standardization have on the sustainability of producing these drugs en mass? Historically, vaidyas collected and prepared their treatments on a patient-to-patient basis. After diagnosis, the physician would scour their garden or forest for the necessary herbs, and take what they deemed to be a sufficient amount. The vaidya took into account how much of the specific herb was available, and would never harvest all that was available. This was a means of conserving the medicinal plants so that they could continue to proliferate naturally. (Loganathan)
Central to the process of mass producing herbal treatments is a technique of aforestation and mono-cropping popular plants. Shiva places these modern techniques in a historical context when she refers to the closing of the commons. The “commons” are places where all individuals are free to make use of the land. This system was famously utilized in England's history. This setup benefits the poor who would otherwise not have access to land. On this land one could raise animals, find fuel or cultivate agriculture. “In the colonial period, peasant were forced to grow indigo instead of food, salt was taxed to provide revenues... and forests were enclosed to transform them into monopolies for commercial exploitation.” (Shiva 26) I draw an analogy between the commons and the unfettered availability of traditional herbs. TNCs are reenacting the enclosure of the commons by patenting and mass producing these plants. Such practices have a negative impact on the environment. The impact is not only in the reduction of biodiversity. On the human level, the impact to the environment is in the creation of barriers to block access by “present day commoners” (or those who would otherwise have free access to the plants).
This is a good illustration of the difficulties in attaining Loganathan's Universal Tradition. The problems that occur in globalizing any practice have already been seen in the industries of food, fuel and water production. Divides in wealth funnel resources away from poorer nations into markets where TNCs can extract higher profits. This leaves the poorer regions with an unequal share of the world's resources. The imbalance of global wealth may make it impossible to satisfy the first essential rule in the Universal Tradition (every person's right to the best medicine). There are already examples of the Loganathan's essential rules being broken.
Acts of biopiracy are a growing problem in the pharmaceutical world. One article published on the Third World Online Network's website discusses why this recent trend has come about.
The recent tremendous interest in Western societies about natural remedies has prompted transnational corporations (TNCs) to hunt for indigenous plants to produce drugs and cosmetics and to exploit related traditional knowledge in Asian countries. Studies have revealed that more than 40 per cent of Western pharmaceutical products contain Asian plant extracts, but these Asian countries have earned little, if anything, in return. (TWN Online)
This provides a good look at how the second essential rule has been broken. In this interaction, the TNCs do not establish links with another tradition. Rather, as the term 'biopiracy' suggests, they act as takers, or pirates. What results is not beneficial for both parties. The Western societies receive gains and the Asian traditions go unrewarded.
Another example of biopiracy is the attempted patenting of the neem plant by Western pharmaceutical companies. Neem is a species native to India that is known as a wonder-drug on account of its medicinal versatility. The neem controversy was taken on by Vandana Shiva, author of Earth Democracy, (a book I relied on for the formation of this paper) and a vocal opponent to corporate globalization. In a judicial victory for Shiva, "the European Patent Office upheld a decision to revoke in its entirety a patent on a fungicidal product derived from seeds of the Neem." (Organic Consumers Association website) This ruling and others like it are great wins for the anti-exploitation contingency, but it is unlikely that they will stop the onslaught of capitalists seeking to benefit by claiming objects of the natural world as their own private property.
This problem of intellectual property rights (who patents what) has fostered a modern space race. This time the competition is not between nations, but between TNCs. The race is not to the moon, but to the patenting of everything that exists on the planet – both inanimate and alive. Patents were distributed in the past as a reward for “inventiveness and creativity.” (Shiva 41) I feel that patents are now used as a corporate tool to lock in possible markets by seeking to control everything that exists. Shiva points to the sad revelation that “not only could cells, genes, plants, sheep, and cows be owned as intellectual property, life had to be owned. That's what Article 27.3(b) of the intellectual property agreement of the WTO imposed on the world.” (Shiva 41) Humanity has seen a change in our view of the world. Once a living system that sustained life, the world (and all within) has become a commodity whose limbs are being systematically claimed.
Shiva illuminates the possible outcome nicely when she says that, "diverting natural resources from directly sustaining human existence to generating growth in the market economy destroys the sustenance economy." (Shiva 18) There is little good to be gained by patenting the neem plant. In my opinion, all that can result from this patenting is the deprivation of an ancient remedy from the culture and region where it originated. When a company tries to increase profits by patenting a living, medicinal plant or its constituent parts, it is in direct contradiction to the promotion of global health.
I can conceive of a counter-example to my claim that biopatenting is frivolous and has only negative repercussions. One could argue that to bring the knowledge of a plant that has positive properties to other parts of the world, a TNC must have the rights to that plant. This could allow the TNC the freedom to properly develop the product for implementation in its new environment.
An anecdote shared with me by Loganathan illustrates clearly the level of corporate deception that results from biopatenting. Medicinal companies in India have begun marketing neem treatments in different parts of India under foreign names. In the north, the product is sold under the name used by southern Indians, and vice versa. Both products are sold by the same company. (Loganathan) The reason this is done is to keep the consumers from knowing what is in the product they are using, since they could conceivably walk into nature and acquire the treatment for free from a nearby tree. The companies do not want their consumers using the readily available natural product. It is in the best interest of the company not to provide the consumer with information, but to create confusion. In this way the consumer will pay for something they do not need and the company will make money. “Corporate globalization... gives rights only to corporations and... sees human and other beings as exploitable raw material or disposable waste.” (Shiva 8) It is my view that this is the case with most instances of biopatenting.
While this last example clearly violates Loganathan's first essential rule, it also violates Vandana Shiva's fourth principle of Earth Democracy, which says, “All beings have a natural right to sustenance.” (Shiva 10) The consumers, duped by money-motivated companies are having their right to sustain themselves with free (or less costly) medical treatments violated.
When I examine cases of corporate greed, I do not think it is not enough to assess the amorality inherent in a company that slaves only to the increase of its profits. I have no problems with an individual or a company striving to make money. It is important for me to assess “sustainability” (especially in the context of research based in Auroville). How sustainable will the outcome be if traditional treatments are packaged, for profit, by globalized health corporations? I alluded earlier to the problems created by the privatization of the food, fuel and water industries. Privatization is analogous to enclosure. Privatization in the water industry has turned water into a commodity. When a resource is commodified, it must be purchased. Therefore, if one privatizes water, the result will be that people will now have to pay for what was once free. This “creates the possibility of excluding others from access to that which is necessary for living.” (Shiva 43) It is my fear that the same result will occur in medicine as traditional practices are globalized, privatized and commodified
Predicting the future of any industry is difficult. The best way to hypothesize about the future is to look at the past for examples. In the past there were extreme problems with globalizing and privatizing agriculture. No child in India suffered death by starvation until the food system was opened up to the global market. (Shiva 34) Since that time unprecedented famine has been the only return for the Indian people. When water was privatized, all that emerged was more debt for poor nations and conflicts over water rights. Though I hope traditional medicine will not be appropriated by corporate globalization, I fear that it is heading in that direction.
One saving grace is that the government of India has invested money into preserving its system. Seed-saving efforts by concerned citizens and public interest groups protect against the possible consequences of corporate farming in the food industry. Similarly, this investment by the Indian government could be a safeguard for Siddha medicine. The fact is that traditional Ayurvedic therapies are being saved as cultural relics. Regardless of the reason for salvation, this saving is invaluable. 4,000 years of medical knowledge would be lost if Siddha were to vanish. At this time the Universal Tradition that I believe to be the ultimate goal of medicine is still tragically flawed. To try and homogenize all practices now would be foolish. The world must wait until the forces of corporate greed are remedied enough to perfect the Universal Tradition.
At that time, provisions can be put in place and the two essential rules can be enforced and protected. Until that happens, diversity in the medical system is the only way to protect against total failure. The same is true in nature and for all systems.


Works Cited

Kanwar, Pavan. Lecture. 3 Mar 2007. College Guest House. Auroville,Tamil Nadu. India.

Loganathan, Dr. Interview. 5 Mar 2007. 24 Anna St. Pondicherry, Tamil Nadu. India.

Langford, Jean. Fluent Bodies. Duke University Press. 2002.

Shiva, Vandana. Earth Democracy: Justice, Sustainability, and Peace. South End Press: Cambridge, MA. 2005.

Thottam, Paul Joseph. Siddha Medicine: A Handbook of Traditional Remedies. Penguin Books: New Delhi. 2000.

Organic Consumers Association. “EU Patent Office Revokes USA "Biopiracy" Patent on Fungicide Derived from Neem Tree Seeds”. Press Release. Viewed 23 Feb 2007. 8 Mar 2005. .

Pleumaron, Anita. “The Hidden Costs of the ‘New’ Tourisms”. Third World Network Online. Viewed 23 Feb 2007. Third World Network Briefing Paper for CSD7, No.1, 1999. .